The rollout of a new volunteer ombudsman program in Iowa in lieu of other moves to beef up nursing-home regulation riled readers, including Mary Bruce.

“Unfortunately, we expect Rolls-Royce care at McDonald’s prices — not only with nursing homes and senior citizens, but with children and child care — our most precious assets. Aides, nurses need to be paid a good wage,” wrote Bruce, of West Des Moines, one of about 15 people to write or call The Des Moines Register Reader’s Watchdog on this subject last week.

On the bright side, my column highlighting a California man’s quest for greater oversight for his father at an Audubon, Ia., nursing home generated a lot of interest from would-be volunteers for the new program, according to Deanna Clingan-Fischer, the state’s long-term-care ombudsman.

Volunteers are currently undergoing screening and training across the state to be eyes and ears for the state’s eight professional long-term-care ombudsmen, who monitor care and bring complaints to the Iowa Department of Inspections and Appeals.

The long-term-care ombudsman’s office hopes to have volunteers across the state trained by the end of 2014, according to Clingan-Fischer. The volunteers will serve more than 30,000 residents in 445 Iowa nursing homes, but it will not serve residents of assisted living centers, she said.

My column from Wednesday also triggered criticism of Gov. Terry Branstad for vetoing legislation that would have brought more oversight to nursing homes.

“Nobody wants to see elderly people not looked after, but those are the policies that are pursued,” said Dean Lerner, who was director of the state’s inspections agency under former Gov. Chet Culver. “That doesn’t work. You need regulation.”

Lerner said the demise of the state’s Resident Advocacy Committees program signaled a move toward less oversight under the Branstad administration. Yet research shows the quality of care is unlikely to improve without more oversight, fines and penalties, he said

“When you don’t regulate and impose fines and there are no consequences … behavior doesn’t change,” Lerner said. “I would like to see the federal and state laws enforced vigorously, which we were trying to do.”

Lerner said nursing home residents fear retaliation if they speak out, so much so Connecticut passed a law this year prohibiting retaliation if they complain to nursing home workers.

Branstad has said he plans to overhaul Iowa’s programs for the aging, but he has not announced what other changes may be in store other than the rollout of the volunteer advocacy program.

Clingan-Fischer acknowledged that many who used to be involved in the resident advocacy program have complained about the decision to eliminate it. But that program not only lost funding, its role had shifted. Many volunteers had come to see themselves as “friendly visitors” and aides to nursing homes’ management, not additional eyes for her office to prevent abuse or substandard care.

“What we also found happening was that the facilities were recruiting volunteers,” she said. “And volunteers were bringing concerns to the office (at the nursing home) instead of DIA or our office.”

Clingan-Fischer said she is hopeful the new volunteer program will help address Iowans’ concerns. “But can we do a better job,” she said. “Everyone can always do a better job.”

Department of Inspections and Appeals spokesman Dave Werning said he believes complaints from the state’s eight ombudsmen have decreased in recent years as the public has become more aware of who regulates nursing homes. Just 13 complaints came from ombudsmen last year, he said. The year before, there were 19.

Werning would not venture an opinion on whether there was enough oversight with the addition of the new volunteer program.

“The Department on Aging, the long-term care ombudsman and the volunteer ombudsmen serve as advocates for Iowa’s elderly, including nursing home residents,” he wrote to me last week. “DIA’s function is regulatory and is facility-focused. While the department and the volunteer advocates share a common goal — protecting the residents — we approach it from two different sides: regulation versus advocacy.”

Lee Rood’s Reader’s Watchdog column helps Iowans get answers and accountability from public officials, the justice system, businesses and nonprofits. Contact her at lrood@dmreg.com or 515-284-8549.